Falling Insulin Requirement Linked to Placental Dysfunction

Share this content:
Falling Insulin Requirement Linked to Placental Dysfunction
Falling Insulin Requirement Linked to Placental Dysfunction

WEDNESDAY, Aug. 16, 2017 (HealthDay News) -- For pregnant women with pre-existing diabetes, falling insulin requirement (FIR) is associated with altered expression of placental antiangiogenic factors and preeclampsia, according to a study published online Aug. 10 in Diabetes Care.

Suja Padmanabhan, M.B.B.S., M.P.H., from Westmead Hospital in Sydney, and colleagues conducted a multicenter cohort study involving 158 pregnant women with pre-existing diabetes (41 with type 1 and 117 with type 2). Thirty-two women had FIR of ≥15 percent from the peak total daily dose after 20 weeks of gestation and were considered case subjects. The primary outcome was a composite of clinical markers of placental dysfunction.

The researchers found that FIR ≥15 percent correlated with an increased risk of the composite primary outcome (odds ratio, 4.38) and preeclampsia (odds ratio, 6.76), and was more common among women with type 1 diabetes (36.6 versus 14.5 percent). Women with FIR ≥15 percent had modestly elevated creatinine; no difference was seen in hemoglobin A1c. Among women with FIR at 25, 30, and 36 weeks, the ratio of soluble fms-like tyrosine kinase 1 to placental growth factor was significantly higher, with differences maintained among those who developed preeclampsia. No difference was seen in placental hormones between the groups.

"FIR is an important clinical sign, among women with pre-existing diabetes, that should alert the clinician to investigate underlying placental dysfunction," the authors write.

Abstract/Full Text (subscription or payment may be required)

Share this content:

is free, fast, and customized just for you!

Already a member?

Sign In Now »


Sign up for myCME e-newsletters


Drug Lookup

Browse drugs by: BrandGenericDisease

Trending Activities

All Professions

More in Home

Opioid Rx, Dosing Often Excessive in Dialysis Patients

Opioid Rx, Dosing Often Excessive in Dialysis Patients

High-risk dialysis population also subject to the risks of long-term opioid use

Nonadherence to Statins  ACEIs/ARBs Risky Post MI

Nonadherence to Statins + ACEIs/ARBs Risky Post MI

Adherence to beta-blockers may not be as beneficial to patients after myocardial infarction

Pulse Ox  Auscultation Reliable for Congenital Heart Screening

Pulse Ox + Auscultation Reliable for Congenital Heart ...

The method significantly improves detection rate of major CHD in newborns

is free, fast, and customized just for you!

Already a member?

Sign In Now »